Do trauma survivors miss out on valuable treatment?

Man sleeping

Hundreds of thousands of people every year in the UK suffer from the severe stress reaction, post-traumatic stress disorder (PTSD).

But Dr Jennifer Wild of the Institute of Psychiatry at King's College London says in this week's Scrubbing Up that they are not getting the help they need.

I'm treating Paul, a young man who was stabbed in London in 2001. Terrifying memories of the attack replay over and over in his mind. He can't concentrate, feels scared, and has been unable to leave his house.

He has post-traumatic stress disorder (PTSD) and has been suffering for 10 years. But it is only now that he's getting treatment.

Sadly this is a common story for trauma survivors.

They wait years before getting the help they need because they're ashamed they're coping so badly and many don't even know that their symptoms can be treated.

But that's not the only problem. GPs don't know enough about what PTSD is and how it should be treated.

An estimated 1.5% of England's adult population suffer from PTSD. That's over 700,000 people and research shows that much less than half this number will go to their GPs for help.

'Nothing to fix the source'

Even when sufferers pluck up the courage to talk to their doctor, surveys show that many GPs are not very familiar with PTSD or the best way to treat it.

Many, like the man I'm treating, are given drugs for depression or insomnia.

That's because some of the symptoms of PTSD overlap with depression and some symptoms, like sleep problems, may appear to be the source of the problem.

But drugs for depression are less effective than talking therapies for PTSD, like cognitive-behavioural therapy. They also have unpleasant side effects.

Sleeping tablets are addictive and are only a patch on one of the symptoms, doing nothing to resolve the source of the suffering.

When GPs hear their patients talking about sleep problems or feeling low, they should also ask if the patient has been through a traumatic event. Then they need to ask about the classic symptoms of PTSD.

Is the patient having unwanted memories of what happened, nightmares, or flashbacks? Are they avoiding reminders, such as talking about what happened or activities, such as driving, that may remind them of what happened?

People who have suffered through a trauma and are suffering with PTSD can get cognitive behavioural therapy, one of the leading treatments for PTSD, through the Improving Access to Psychological Therapies Programme (IAPT). They can self-refer or go to their GP and ask to be referred to a local IAPT service or to one of the UK's specialist trauma clinics.

But there are other ways to get treatment. Many clinical research centres offer treatment as part of ongoing audit or research development programmes and patients can usually get access to this treatment within weeks.

So to redress the balance between the number of people suffering from PTSD and the numbers getting treatment, patients and GPs need to be aware of the symptoms that make up the PTSD diagnosis, understand that some symptoms may overlap with depression, and to be aware of the treatments that are available.


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  • rate this

    Comment number 8.

    PTSD is a complex illness but it is treatable. I have found that the key is a variety of treatments to support you through the process. I've used acupuncture, massage, psychotherapy, and hypnotherapy along with meditation. I recommend research - drugs can be used to stabilise emotions but they can also mask emotions and this is when acupuncture, massage, exercise, diet & meditation can help.

  • rate this

    Comment number 7.

    desnos I've been there and it's naff. I had an excellent GP who was on the ball, the mental health nurse though was very dismissive. Again it's all down to training. Healthcarer's need to be less judgemental.
    Meds should only be used for the period it takes to get the person ready for CBT then discontinued as soon as poss. One of the side effects of the SSRI's is suicidal ideation.

  • rate this

    Comment number 6.

    PTSD is not a particularly difficult thing to diagnose but its a horrible thing to be stricken with. Many GP's don't spot it when their patient keeps turning up with things wrong with them and others don't believe PTSD exists. Medicines do help but should not routinely be given, but the reality is, meds do get prescribed and the person forgotten about. A fair number commit suicide.

  • rate this

    Comment number 5.

    Got to add that I think the drugs are poor option. Just look up the side effects for Citalopram or Paroxetine. If your anxious would you really want these as well?

    There is so much collateral damage done by PTSD, the sooner it is identified and CBT initiated, the better the outcome all round.

    Government has promised funding for IAPT in it's new policy however waiting times are still too long.

  • rate this

    Comment number 4.

    Part of the issue is that some people use alcohol and drugs to control the anxiety and health carers try to won't treat the PTSD before a detox, which is unrealistic. Also the medical model prevails, first port of call is anti-depressants.

    Healthcare professional's training needs to address this.

    A qualified professional also means mental health nurses, psychologists and counsellors.

  • rate this

    Comment number 3.

    1 Flashie

    'difficult for suffers and their loved ones'

    Its more difficult when one of the loved ones is responsible for the trauma. This happens more often that many think.

    'a qualified professional'

    I might be wrong on this but my understanding is only psychiatrists are qualified in this regard. However others appear to be offering diagnosis so it is no surprise there are problems

  • rate this

    Comment number 2.

    I was left undiagnosed with PTSD for nineteen years following an event that happened to me whilst serving in the RAF . I am getting some treatment ,but my CBT has said herself I was left too long for anything to really stop the flashbacks etc .

  • rate this

    Comment number 1.

    Good to see this article!

    It's so important to keep seeking help for PTSD, and to work with a qualified professional when you do. Symptoms usually don't go away on their own, and can make life extremely difficult for sufferers and their loved ones.

    Better education for GP's, as well as expanded information on how patients can access appropriate treatment can only help.


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